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Comment by exelius | Hacker News Reader

From personal experience in my youth, I can definitely say that psychedelics (mushrooms in particular) can help you think in different ways that make your problems seem trivial and imminently solvable. Those changed patterns of thought seem like a revelation at the time -- like the clouds opened and an answer came down from the sky. So I'm not at all surprised with this.

That said, this study had only 12 participants with no control group -- so it's hard to draw any meaningful conclusions. But as a canary study, it says that there might be something here, so further, more rigorous studies are warranted.

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This seems to be the important quote on the findings: “We can give psilocybin to depressed patients, they can tolerate it, and it is safe. This gives us an initial impression of the effectiveness of the treatment.”

All the legal hurdles they had to pass to make this happen are quite impressive. Hopefully they've eeked open that door a bit for further study.

Roland Griffiths at John's Hopkins is trying to do proper research on psilocybin, i.e. with control groups. Although it's kind of hard since the effects of psilocybin are rather noticeable.

http://www.tedmed.com/speakers/show?id=526372

Just in case anyone here hasn't already seen this: https://xkcd.com/1462/

Yeah, it looks like the study linked in the original article didn't do the measurement on the subjects while they were under the influence, but rather some time after the fact. In my experience, psilocybin can have a lasting psychological effect long after the physiological effects wear off.

I'm thinking more along the lines of this one: https://xkcd.com/790/

Not every medical procedure can or has to undergo double blind testing with control groups.

Pretty much any treatment that has very aggressive effects is usually done without it.

Even treatments that can be tested using a control group are quite often tested without it if you can isolate your metrics well enough.

But technically you can still use a control group for psychoactive drugs because in every trial the first rule is not to give the test subjects any information about possible effects or side effects in order not introduce bias, you also quite often isolate the subjects from each other completely.

I'm also not sure if the dose that is given in this case is even high enough to induce hallucinations in the first place.

> possible effects or side effects in order not introduce bias

giving people psychedelics without telling them seems pretty irresponsible to me even in a controlled setting.

I would guess that not telling someone could also affect the outcome. You might have a different experience from the treatment if you're wondering and waiting.

I forget which interview I was listening to about doing LSD research but I remember the gist of the quote: "We tried doing double-blind studies, but 15 minutes into the experiment we realized it was pointless. The people who were given LSD... they knew they'd been given the real stuff, the scientists knew very obviously who'd been given the real stuff... There's no way to give someone LSD and not have everyone in the room know what's going on."

That's a very interesting problem. I wonder if one solution to the 'control group' is for the control to be an alternative intoxicant (i.e. not another psychedelic).

Can't they just lower the dosage drastically?

You mean like micro-dosing and homeopathy? And see if they're not depressed for the next 15 seconds?

You could say you were testing drugs for depression and give one group psilocybin and the other something like prozac rather than sugar pills.

Microdosing may remove the "rather noticeable" side effects while producing a similar reduction of anxiety/depression.

Here's a thing I don't understand - no control group.

Surely we've been trying to treat people with severe, long term depression by other means and not had success. This surely wasn't the first treatment that these people tried in trying to treat their long-term misery. How are both of those things taken together not as good as a control group that allows you to draw meaningful conclusions. It really sounds to me (although it would be better to see the quantification in the source docs) that this is a strong enough result to rule out noise.

If your results are strong enough, you don't need a control. If all 12 participants died while undertaking the trial would we say that it needs to be re-run with a control to be meaningful?

The results look strong. Go for pre-registered replication right away. Sod the control group. Everyone with severe long term depression outside the study is already suffering enough to be the control.

That's why it's a canary study. Sure, it looks good, which means it's worth spending the money on a larger study. And yeah, there are lots of people with severe long-term depression, so find some of them, measure their mood over the same time period, and make absolutely sure that the effects you're ascribing to the substance you're testing aren't caused by something else.

You always need a control group because you can't control for every externality over the exact time period the study was conducted. Maybe the weather was especially nice for those 3 months and the control group feels happier as well? We need a way to quantify the results and be able to answer those questions.

Always be careful with the conclusions you draw from studies without control groups. Small studies without control groups are very cheap to run, so you can run the same study 15 times and only report on it when you get the results you're looking for. Not saying that's what happened here, but we have to apply the same standards of proof to all drug studies or else they don't mean anything. The purpose of this study was likely not to prove "hallucinogens can cure depression" but rather "mushrooms are potentially effective and don't appear to have any glaring safety issues".

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